TY - JOUR
T1 - Predictive factors for late recurrence in patients with stage T1 clear cell renal cell carcinoma
T2 - A multiinstitutional study
AU - Ha, Yun Sok
AU - Park, Yong Hyun
AU - Kang, Seok Ho
AU - Hong, Sung Hoo
AU - Hwang, Tae Kon
AU - Byun, Seok Soo
AU - Kim, Yong June
PY - 2013/3
Y1 - 2013/3
N2 - Background: The purpose of this study was to identify predictive factors for late recurrence in Korean patients with stage T1 clear cell renal cell carcinoma (RCC) more than 5 years after treatment with radical nephrectomy (RN) or partial nephrectomy (PN). Patients and Methods: Between 1999 and 2011, 3567 patients with RCC underwent RN or PN at 5 institutions in Korea. Of these, 423 patients with pathologically confirmed stage T1 clear cell RCC remained free of disease for at least 5 years. To determine the pathologic and clinical factors that influenced late recurrence, univariate and multivariate analyses using the Cox proportional hazards model were performed. Recurrence-free survival curves were estimated by using the Kaplan-Meier method. Results: During a median follow-up period of 83.9 months (range 60.0-156.4 months), late recurrence was observed in 14 of the 423 (3.3%) patients. Univariate and multivariate analyses revealed that symptoms at diagnosis and pathologic T stage were independent predictive factors for late recurrence. Patients with symptoms at diagnosis or stage T1b disease had a significantly shorter time to late recurrence than did those who were asymptomatic or had stage T1a disease (log-rank test P =.027 and P =.034, respectively). Conclusions: Late recurrence in stage T1 clear cell RCC is a relatively rare event. Predictive factors for late recurrence were identified in the present study. Careful long-term follow-up is necessary, especially in patients who have symptoms at diagnosis or stage T1b tumors, even if they have been free of disease for more than 5 years.
AB - Background: The purpose of this study was to identify predictive factors for late recurrence in Korean patients with stage T1 clear cell renal cell carcinoma (RCC) more than 5 years after treatment with radical nephrectomy (RN) or partial nephrectomy (PN). Patients and Methods: Between 1999 and 2011, 3567 patients with RCC underwent RN or PN at 5 institutions in Korea. Of these, 423 patients with pathologically confirmed stage T1 clear cell RCC remained free of disease for at least 5 years. To determine the pathologic and clinical factors that influenced late recurrence, univariate and multivariate analyses using the Cox proportional hazards model were performed. Recurrence-free survival curves were estimated by using the Kaplan-Meier method. Results: During a median follow-up period of 83.9 months (range 60.0-156.4 months), late recurrence was observed in 14 of the 423 (3.3%) patients. Univariate and multivariate analyses revealed that symptoms at diagnosis and pathologic T stage were independent predictive factors for late recurrence. Patients with symptoms at diagnosis or stage T1b disease had a significantly shorter time to late recurrence than did those who were asymptomatic or had stage T1a disease (log-rank test P =.027 and P =.034, respectively). Conclusions: Late recurrence in stage T1 clear cell RCC is a relatively rare event. Predictive factors for late recurrence were identified in the present study. Careful long-term follow-up is necessary, especially in patients who have symptoms at diagnosis or stage T1b tumors, even if they have been free of disease for more than 5 years.
KW - Multiinstitutional study
KW - Prognosis
KW - Recurrence
KW - Renal cell carcinoma
UR - http://www.scopus.com/inward/record.url?scp=84874514186&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84874514186&partnerID=8YFLogxK
U2 - 10.1016/j.clgc.2012.08.008
DO - 10.1016/j.clgc.2012.08.008
M3 - Article
C2 - 23017336
AN - SCOPUS:84874514186
VL - 11
SP - 51
EP - 55
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
SN - 1558-7673
IS - 1
ER -